Minododazin: Translating an Algonquin Tradition of Respect into Youth Well-being in Rapid Lake,

Heather Kooiman, MScN; Mary Ellen Macdonald, PhD; Franco Carnevale, RN PhD; Carolina Pineda, PhD; Waylon Nottaway; Serge Vignola, RN Abstract Introduction Aboriginal people in face important obstacles Respect is a core value that promotes personal and to the achievement of optimal health and well-being. community well-being for many Aboriginal peoples For Aboriginal youth in particular, these obstacles have in Canada. Widespread practices of caring for the lead to health disparities relative to the non-Aboriginal population. This study used the qualitative method of self, one’s community, and nature reflect this core focused ethnography to explore this pressing concern value. Notwithstanding this tradition, Aboriginal from the perspective of the youth, educators, health care people in Canada face important obstacles to the workers, parents, and elders of an Algonquin community achievement of optimal health and well-being. located in Rapid Lake, Quebec. The overall goal was to For Aboriginal youth in particular, these obstacles assist community youth workers to design a culturally have led to health disparities relative to the non- relevant program to promote well-being among local youth. The program and findings that resulted from this Aboriginal population. Higher incidences of drug, study suggest that the social practices encompassed within alcohol, and tobacco use, as well as higher rates of the Algonquin tradition of minododazin correspond with sexual abuse, sexual exploitation, sexually transmit- those researchers positively correlate with youth well- ted infections, HIV/AIDS, teenage pregnancy, sui- being. The program and findings that resulted from cide, and obesity have been reported for Aboriginal this study are of value to other Aboriginal communities youth (Assembly of and First Nations seeking to address similar health concerns among their youth. Governance Committee, 2007; Fenton, 2001; Health Canada 2009; Steenbeek, 2004). Keywords: focused ethnography, participation, well- Additionally, there is a significant difference in being, self-respect, substance use, sexual health, cultural knowledge, Aboriginal, youth drug and alcohol use in Aboriginal youth compared to their non-Aboriginal counterparts. For example, 59% of Aboriginal youth smoke tobacco, compared to 24.4% of non-Aboriginal youth (Health Canada, 2009). Factors such as low socioeconomic status and a long and devastating history of coloniza- tion, assimilation, and residential schools have been linked to these important health issues (Reading, 2009; Mussell et al., 2004; Clarke 2007; Tousignant and Sioui, 2009; Tu et al., 2008). The concepts of self-respect and self-esteem are important to consider when dealing with the issues surrounding substance use and sexual health

© Pimatisiwin: A Journal of Aboriginal and Indigenous Community Health 10(1) 2012 1 2 © Pimatisiwin: A Journal of Aboriginal and Indigenous Community Health 10(1) 2012 for youth, as high levels of self-respect and self- The Project esteem have been positively correlated with well- being (Aboriginal Nurses Association of Canada, According to the literature, self-respect or “having 2002). There is, however, a lack of research on the regard for one’s character” (Orkar, 1997) is closely applicability of such concepts in the development connected to decisions regarding sexual activity and of culturally appropriate substance use and sexual substance use (Aboriginal Nurses Association of health initiatives for youth in Aboriginal commun- Canada, 2002). In a study conducted by Goff and ities (Assembly of First Nations and First Nations Goddard (1999), it was demonstrated that regard- Governance Committee, 2007). less of their sociodemographic background, North Through an ongoing partnership between the American adolescents who valued self-respect were McGill School of Nursing and the Kitiganik Health more likely to delay alcohol and tobacco use as well Clinic of Rapid Lake, Quebec, our team used the as sexual activity until an older age. For participants qualitative method of focused ethnography to ex- of that study, core values associated with self-respect plore health concerns for local Algonquin youth were found to mediate engagement in antisocial be- and related obstacles to their well-being. Our over- haviour (Goff and Goddard, 1999). The research on all goal was to assist community youth workers to Aboriginal youth makes similar observations. In one design a culturally relevant self-respect program to study on the sexual behaviour of Aboriginal adoles- promote healthy lifestyle choices among youth par- cent girls, it was shown that those who remained ticipants. To ensure the relevance and practical ap- abstinent listed self-respect as a key reason for their plicability of such a program, the input of commun- behaviour (Morrison-Beedy et al., 2008). Another ity members including youth, educators, health care study asked Aboriginal youth to define healthy sex- workers, parents. and elders was sought at all stages uality. Included in their answers were the following: of this project. We believe our program and findings “respect for myself,” “respecting the boundaries,” are of value to other Aboriginal communities seek- it “does not have to involve sexual intercourse,” ing to address similar health concerns among their and it “can mean love yourself and being loved by youth. your parents and close friends” (Aboriginal Nurses In the following article, we provide an overview Association of Canada, 2002). Following from this of the health literature demonstrating the link be- literature, our research asked: How can the well-being tween youth well-being and self-respect. Following, of Aboriginal youth be addressed through a self-respect we provide a brief history of the Algonquin of framework? Barrier Lake to familiarize the reader with the con- Setting text of this research, and then outline the participa- Rapid Lake, Quebec, is a community of approxi- tory approach we used to design and conduct our mately 400 Algonquin people, located in northwest- project. We then describe the resultant culturally ern Quebec, approximately 130 kilometres north relevant self-respect program we completed with of Maniwaki and 150 kilometres south of Val-d’Or the youth, and our research findings which high- (Aboriginal Portal, 2004). Historically, light the importance of self-respect, or minododaz- the Algonquin of this community resided some 75 in, in traditional Algonquin culture. We found that km away on the territory surrounding Barrier Lake. minododazin can provide hope for youth; however, Though they relocated to Rapid Lake around 1930 we also learned about serious personal and social they continue to be known as the Algonquin of barriers youth experience to achieving minododaz- Barrier Lake. in. We conclude by discussing the implications of Like other Aboriginal communities throughout using Indigenous health philosophies for programs the region, Rapid Lake has limited resources to ad- and policies, and specifically with ideas for future dress the many needs of its inhabitants. There is one community-based activities to support youth health elementary school, a youth centre, a daycare, and a and well-being. police station. The nearest grocery store is located Minododazin: Translating an Algonquin Tradition of Respect into Youth Well-being in Rapid Lake, Quebec 3

130 kilometres away and the closest high school a McGill Masters in Nursing student lived in Rapid even further away in a predominantly non-Aborig- Lake for three months, during which she conducted inal city. The local health clinic, the Kitiganik Health a clinical placement as well as directed this research Clinic, services the community’s immediate health project. Working together with two supervisors needs and refers patients to medical specialists in from McGill, the head nurse at the Kitiganik Health southern cities when necessary. Run by Health Clinic, and two local Algonquin community work- Canada, this clinic is staffed by nurses from outside ers, at the request of the community our aim was Rapid Lake and local health care workers. Health to help to develop a program on self-respect to pro- care professionals including a dentist, a dental hy- mote the well-being of local Algonquin youth. We gienist, and a psychologist come from outside the employed a participatory approach to ensure that community on a weekly or monthly basis. the expertise of community members was included Over the past two decades, there have been im- at each stage of program development. This research portant political and social disruptions in the com- was approved by the Institutional Review Board of munity, which can be traced to tensions between McGill University and was carried out in accordance local interests and the agendas of the Quebec and with McGill’s policy on the ethical conduct of re- Canadian governments. For example, the devastating search involving human subjects, especially minors. regimes of control and assimilation that character- Written informed consent was obtained prior to all ized Canada’s relations with Aboriginal peoples since participation; in the case where participants were the early years of colonization have led to present- under 18 years old, parental consent and youth as- day socioeconomic vulnerabilities. In particular, sent were obtained. The methodological approach the legacy of residential schools and related abuses for this project was focused ethnography, a quali- (physical, mental, sexual, emotional, spiritual) con- tative methodology used to understand a focused tinue to disempower community members as past health-related issue in a cultural context (Polit and traumas transfer across the generations (Aboriginal Beck, 2006; Speziale and Carpenter, 2007). This Nurses Association of Canada, 2002; Clark, 2007). ethnographic approach, with its roots in anthropol- In addition to the radical disturbance of traditional ogy, combines participant-observation with other family life, language, and values through the dis- data gathering methods (e.g., interviews), the goal location of Aboriginal children and the often brutal being to understand a group’s cultural patterns, “re-socialization” to European standards, these past experiences, and lifestyles (Polit and Beck, 2006; abuses have been linked to an on-going cycle of so- Speziale and Carpenter, 2007). Iterative reflection of cial dysfunction and disorder including high rates of the data collected is an important part of this type suicide, domestic violence, sexual abuse, and inter- of research, allowing for the continual reassessment personal maladjustment (Mussell et al., 2004; Clark, and adjustment of the project’s questions, direc- 2007; Reading, 2009; Assembly of First Nations and tions, and findings based upon ongoing data gath- First Nations Governance Committee, 2007). More ering (Polit and Beck, 2006). recently, in 2008 the community organized a protest The student-researcher used participant-obser- against the Quebec government’s unauthorized log- vation, individual and group interviews with key in- ging of land designated for protection in the 1991 formants, and a focus group to better understand Trilateral Agreement, resulting in violent backlash by the health concerns affecting local youth. This pro- provincial police. It is in the context of these social, vided community-generated perspectives on the political, and historical events that concerns for the historical and environmental factors that play a role well-being of Rapid Lake youth must be understood. in youth well-being. Descriptive and analytic field- Design notes were recorded after all research interactions thus contributing to the data analysis (Polit and Through on ongoing partnership between the McGill Beck, 2006). The selection and recruitment of re- School of Nursing and the Kitiganik Health Clinic of search participants was done with the help of the Rapid Lake (Lang et al., 2010; Sherman et al., 2011), 4 © Pimatisiwin: A Journal of Aboriginal and Indigenous Community Health 10(1) 2012 staff at the Kitiganik Health Clinic, and the project respect and healthy behaviours with a selection unfolded as follows. of possible answers (A through D). Each team The project was divided into four phases over conferred and held up the letter they felt best the course of a three-month period (September- answered the question. The team with the cor- December, 2010; See Appendix A for details). Phase rect answer was awarded one point, and the an- One involved face-to-face interviews with key in- swer was then discussed together with the larger formants (community health care workers, parents, group (See Appendix B for examples of the ques- an elder, an educator, and a nurse), two group inter- tions). This interactive format proved effective as views with youth (from grade 5/6 and grade 3/4), youth gained confidence asking and responding and a focus group with parents who had children to questions they previously felt too shy to ar- in elementary school. All interviews and the focus ticulate. group were facilitated by the student-researcher • Pilot Program Craft Activity: An animal hide using open-ended questions; all were audio-recorded was donated by a local hunter for the craft ac- and transcribed for analysis where necessary. tivity. The goal of the activity was for youth to Many of the youth participants were initially paint empowering statements and images on shy to engage in conversation about sensitive topics the hide that reaffirmed the topics discussed related to their well-being. To faciliate discussion previously (See Appendix C). around themes like puberty and sexual health, the After both activities, verbal feedback was so- student-researcher created a question box where licited from the participants using open-ended students could write their comments and questions questions. anonymously on a piece of paper. The box was left During Phase Three, the student-researcher com- in the classroom for students to access at their com- bined feedback from the pilot program with her own fort and convenience. In addition, students were in- observations to finalize the self-respect program. vited to participate in a brainstorming activity that The final program included a similar game but with addressed their personal strategies for maintaining additional questions/answers and the continuation self-respect. They were asked to fill in the statement of the painting activity; it was attended by five par- “I respect my [blank] by [blank].” For example, one ticipants (2 boys and 3 girls). The completed piece student wrote, “I respect my body by not taking of art was then put on display at the youth centre. drugs or alcohol.” These two techniques helped ani- Bright and bold, it stood as a symbol of the youth’s mate participants and encourage group discussion. commitment to well-being. To address the issue of In Phase Two, the youth responses from the environmental respect, the student-researcher or- brainstorming activity were combined with the ganized an activity to pick up garbage around the anonymous questions in the question box, as well community which was attended by approximately as the analysis of the key informant interviews. A ten youth. culturally relevant, youth-friendly pilot program on Finally, in Phase Four, a final analysis was con- self-respect was then designed and launched. This ducted of the entire data set, and the thematic find- pilot program, designed in collaboration with com- ings were shared with members of the community munity health care workers, included a game and a in the form of a community presentation at the lo- craft for youth at the local youth centre. Five boys cal health centre. The youth played part of the game and four girls between the ages of 9–12 years old for the audience to show the interactive style of participated as follows. learning, and presented their animal hide artwork. • Pilot Program Game: The game consisted of Verbal feedback was sought, during which commun- multiple-choice questions that challenged youth ity members agreed with the findings and stressed to engage their knowledge on self-respect and that the results should be shared with people out- well-being. Two teams were created and the side the community to create an awareness of the student-researcher read out questions on self- disparities that exist. Importantly, the youth asked Minododazin: Translating an Algonquin Tradition of Respect into Youth Well-being in Rapid Lake, Quebec 5 the student-researcher to play the entire game again as an all-encompassing form of respect that extends after the presentation. beyond the individual self. As one person put it:

Data Analysis and Rigor There’s self-respect to yourself, to your body, During each phase, data were analyzed to determine there’s self-respect to your family and then there is the direction for the subsequent phase. Interviews self-respect as a Native person. It’s not only about the body. Self-respect in Algonquin means to take and verbal feedback were analyzed thematically and care of yourself, Minododazin. coded according to recurrent themes; the themes were then compared across interviews and new Through these interviews we learned that respect codes were added or changed as the data was com- is a core value of Algonquin culture that simultan- piled. Feedback from youth and community health eously integrates positive regard for the self, the workers, along with observational data, were ana- community, and the environment. This integrative lyzed and integrated into the self-respect program approach reflects Algonquin understandings of the design. self as intimately and inseparably related to the so- To ensure methodological rigour, a number of cial and material world. This world view challenges strategies were implemented as follows: Three forms any Western attempt to divide the expression of of triangulation were employed: a) interacting with “respect” into specific types or forms (e.g., self-re- different groups of people ensured data source tri- spect, community respect, environmental respect). angulation; b) investigator triangulation was satis- Instead, participants identified a broad range of per- fied by involving McGill supervisors in the analysis sonal and social practices that were operationalized and preliminary findings; and c) method triangu- through the local concept of minododazin. These in- lation occurred by using participant observation, a cluded the following: taking care of one’s personal focus group, interviews, and a pilot program (Polit health needs (including dental needs, food choices, and Beck, 2006). To ensure a rigorous analysis, the exercise) and overall hygiene (including appear- student researcher maintained a personal reflexive ances); personal aspirations (academic and profes- journal to provide continuous self-critique and self- sional goals) and life choices (e.g., avoiding alcohol appraisal (Koch and Harrington, 1998). Finally, an and drug use, and early sexual activity); pride in audit trail was maintained by weekly descriptive and their Aboriginal cultural heritage including speak- analytic fieldnotes to one McGill supervisor. ing Algonquin; respect for others (including not stealing, teasing, or hurting others; instead helping Results others and being polite) and especially for elders The data gathered in the course of designing the self- (e.g., bringing them bush food); and respect for the respect program demonstrate a number of salient environment including animals (e.g., leaving tobac- themes that help to explain how and why the youth co after killing a wild animal as thanks). in Rapid Lake struggle with issues of self-esteem and In all cases, participants noted that the social self-respect and often participate in risky health be- practices associated with minododazin were learned haviours. The major themes that emerged in our an- through the teachings of elders and parents. As it alysis are as follows. was explained by one local health care worker: Minododazin, A Holistic Algonquin Usually grandparents and parents teach this [minododazin] especially when they go into the Understanding of Respect bush … it depends if grandparents brought their When participants were asked to define “self-re- kids to the bush and taught them about self-re- spect” in their own terms, no notion of exclusive spect. My parents brought us to the bush so we care or regard for the self was evoked in their re- learned how to do things like how to cook and live sponses. Instead, participants referred to the local in the bush. I learned how to take care of myself. It depends if the parents bring their kids to the bush concept of minododazin, translated literally to mean and would teach them about traditional stuff then “take care of yourself.” Minododazin was described their kids would learn about self-respect. 6 © Pimatisiwin: A Journal of Aboriginal and Indigenous Community Health 10(1) 2012

In qualifying these bush lessons as “traditional poor dental health, a lack of exercise and unhealthy stuff,” this community member highlighted an im- eating among youth. Also distressing were youth be- portant aspect of Algonquin culture. She also point- haviours surrounding substance use and sexual ac- ed to the conditional nature of the transfer of trad- tivity with their life-altering consequences such as ition from one generation to the next: learning to physiological damage, addiction, sexually transmit- “take care of yourself” in the Algonquin sense “de- ted diseases, and pregnancy. Once again, self-respect pends” on whether or not youth have access to the or, more precisely, a lack thereof, was noted to pre- same opportunities for mentorship as she did grow- dispose local youth to these patterns of risky behav- ing up. iour. One elder shared his concerns in stating: The Intergenerational Impact of They [youth] don’t have respect for themselves. I see them get drunk and stoned. I see the girls, they Residential Schools on Youth get drunk and then they will sleep with this guy Vulnerability or that guy. Some of them have boyfriends already During individual and group interviews it was often at thirteen or fourteen years old. I see a lot of kids emphasized that much Aboriginal history and cul- that don’t care what they are doing. They don’t ture was lost in the residential school experience. A have respect for their body or themselves. health care worker shared her thoughts in saying, In conversations with community members it There is a generation that went outside the com- was often suggested that respect, embraced as a core munity, to residential school, they cut the tie with value, enables youth to implement boundaries and the parents around 1950. For this generation, they say “no.” Reports of young people “punching others don’t know their culture and it is difficult to pass in their private parts” and giving each other “hick- their culture to their kids. ies” prompted one mother to observe:

The process of assimilation, facilitated through col- If they [youth] knew about self-respect they would onial institutions like residential schools, has had know that people shouldn’t touch them there long-term consequences in communities like Rapid [private body parts]. Lake. Community members made explicit links be- A similar sentiment was articulated by a health tween the past and the present in their articulation care provider in the following remark: of the most pressing problems faced by local youth. One mother explained, Self-respect protects them against the aggression [sexual] because it is important to learn that when Youth have no respect for who they are. Really it’s they are not comfortable in a situation, they are not their fault because they don’t know who they not being respected. It is important to learn that are, they don’t know where they came from, and young, it’s not okay for that person to do that to they don’t know the history. It’s being lost because me. the elders don’t share it with us. Learning to say no to sexual aggression as a Echoing the point made by the community member form of “taking care of yourself” also helps young quoted above, this mother framed a perceived lack people say no when exposed to other factors that among youth (“Youth have no respect for who they threaten well-being. The trend of substance abuse are”) in terms of a lost opportunity for mentorship among youth as young as ten years old is a primary by local cultural experts. example. When youth in the pilot program were Without a firm grounding in their cultural asked to comment on this trend, their tone was re- heritage, the youth of Rapid Lake are seen to be vul- signed: “[Young] people do drugs because everyone nerable. From a health care perspective, this vulner- else is doing it,” noted one youth man matter-of- ability is expressed in a constellation of behaviours factly. By quickly adding that “older people [youth] deemed disadvantageous for young bodies. In inter- tell us to [do drugs]” he mirrored the concerns of a views with staff at the Kitiganik Health Clinic, wide- community health care worker who said: spread concern followed from observable patterns of Minododazin: Translating an Algonquin Tradition of Respect into Youth Well-being in Rapid Lake, Quebec 7

Some kids are pulling other kids … there are a few munity. In the eyes of another mother, the problem kids around here that are forcing other kids, ask- was as follows: ing them to chip in money so they can get drugs.” And the high school students, someone needs to Limited Resources for Youth and do something about the high school students. Geographic Isolation They are moving to a new town, they lived on the Though participants of all ages agreed that youth ‘res’ their entire lives, and they want to make new were vulnerable to peer pressure when it comes to friends and they want to be cool like the people in town schools. So they do pretty much anything risky behaviours, there was also widespread consen- that the town kid will get them to do. We have a sus that factors like limited resources in the com- lot of kids coming back on ecstasy and speed and munity and their geographical isolation contribute it’s physically obvious. to this vulnerability. The words of one elder were telling: Participants felt that if there was a local high school, youth would be spared the dislocating move They [parents] need activities for the [young] to Val-d’Or and would continue to pursue their aca- people … kids do nothing but sit around their demic studies. Further, youth would benefit from house smoking and getting stoned. Last year they the ongoing support of their immediate and extend broke a lot of windows at the lodge. It’s ’cause they have nothing to do during the day. families as they confronted the many challenges of adolescent life. This concern with boredom as a factor predispos- ing youth to destructive behaviour was shared by Ambitions and Goals another participant: “They need more recreational “Youth really think low of themselves,” stated one grounds so they can stay away from drugs and al- parent. “They never think they could be lawyers or cohol.” For both individuals, the lack of recreational doctors or anything.” According to this parent, low alternatives available in Rapid Lake combined with self-esteem limited the ambition of local youth. But, a lack of healthy food alternatives (without a local as was also noted, young people have few oppor- grocery store youth subsist on a diet of processed tunities to learn about and explore viable career op- food) predisposed youth to unhealthy lifestyles. tions: “They need to see other things that are out Additionally, participants lamented the absence there.” From this perspective, exposure to “other of a local high school for the community’s youth. things that are out there” would help youth imagine Not only does the move to Val-d’Or for high school themselves in professional roles and plan their lives prove challenging for many youth as they are forced accordingly. The alternative — watching one young to adapt to a new environment, it has also led to person after another fall into the same cycle of de- high dropout rates and increased access and expos- structive behaviour because of a lack of life goals — ure to drugs and alcohol. One mother noted: is heartbreaking for many parents. Another parent framed the situation this way: They smoke marijuana and cigarettes, for a fact, it’s the main thing around here. Not too long ago, They still do it [drinking, drugs, etc.] but I think since they leave the reserve to go to high school, that they feel that they have no choice. They feel now there are more drugs, they are becoming like they will be stuck here for the rest of their aware of all these other drugs. I know my son was lives. One of the little boys said, I’ll probably be drinking a couple weeks ago and I notice it’s only here my whole life and live on welfare and I’ll when they go away to town to do that. probably be living in that little shed over there. I told him not to say that. That youth tend to bring these harmful sub- stances back to Rapid Lake on weekend visits and In conversations with the student-researcher, holidays also worries parents. The general sense is youth shared feelings that could be read as symp- that this behaviour is disrespectful since youth pri- tomatic of this sense of disillusionment with the oritize their own social needs over those of the com- future. When asked to identify negative aspects of 8 © Pimatisiwin: A Journal of Aboriginal and Indigenous Community Health 10(1) 2012 growing up, their responses included “getting in makes it so much more real because it happened fights and drinking alcohol” and “having kids.” In to me and I want it never to happen to my child contrast, the positive aspects included “being a doc- and if it is happening to my child it’s almost like I would rather not know it. I do tell my daughter tor” or “going to college.” those are your private parts and that you have per- Teen Pregnancy sonal space and if anyone ever hurts you, you tell mom because mom will take care of you and will Both adults and youth reflected on the commun- never blame you. But it’s really hard, I get goose- ity concern with teenage pregnancy. Pregnancy bumps even talking about this. It’s really hard. forces young mothers to abandon their studies pre- maturely; in the majority of cases, the challenge Another parent who had experienced sexual of juggling academic responsibilities with those of abuse at a residential school explained that the im- child care proves too overwhelming to support a re- pacts of abuse continue down through the genera- turn to school. The consequences of not finishing tions: high school are felt across the community over the It’s this cycle [of abuse] that started with the resi- long-term as undereducated youth contribute to dential schools. It affected the kids that went to the already high rates of unemployment in Rapid residential schools, they grew up and it affected Lake. Further, adults worry that pregnancies are be- their parenting and so many aspects of their life ing planned strategically by youth who see financial and it’s still affecting us now even though residen- benefits to having a child. As one mother observed: tial schools are gone. “I notice that a lot of people around here are try- Overall, it was clear that the community wanted ing to get pregnant when they are young and it’s the youth to learn about sexual health, and partici- because of the money, they get social assistance.” In pants suggested that having an intermediary, such these terms, youth who lack the resources to fulfill as a nurse, to speak to their children on their behalf their immediate desires (e.g., having money) will would be highly valued. One parent also suggested find a way to do so despite short- and long-term the possibility of “sexual courses” to teach parents consequences for themselves, their children, and the how to speak with their children. community at large. While children are greatly val- ued by the Algonquin as in many Aboriginal com- Discussion munities, parents were clear that they would pre- It is in the context of social, political, geographical, fer their own children to finish their education and and historical issues that concerns with the well- achieve a career before starting a family. being of Rapid Lake youth must be understood. Difficult Parenting Conversations. Research participants cited geographical isolation, The final theme that emerged has to do with the dif- limited resources within the community, and past ficulty many parents had speaking to their children traumas related to the residential school experience about healthy sexuality and addictions. While some as being directly related to the most pressing prob- parents were too shy to broach these sensitive issues, lems faced by their youth today. Included in their some also felt that their children would be more concerns for their youth was a long list of issues: likely to engage in sex if they were taught about it. drug and alcohol use and dependency; sexual activ- For other parents, the reluctance came from their ity leading to abuse and teen pregnancy; social de- own personal experiences with sexual abuse and linquency; abandonment of academic and life goals; with addicitons. Some spoke about their own legacy lack of knowledge and pride in their Aboriginal lan- with sexual abuse, and how it affected their parent- guage and heritage; unhealthy eating and inactivity; ing. As one mother said: and a lack of respect for the self, others, and the sur- rounding environment. Though participants spoke I think about things like that and what if it is hap- passionately about a strong Algonquin tradition of pening to my daughter. I can talk to others about respect, encompassed in the local term minododaz- it but it’s scary to talk to my children because it Minododazin: Translating an Algonquin Tradition of Respect into Youth Well-being in Rapid Lake, Quebec 9 in, they pointed to structural and historical factors deavoured to support the local notion that minodo- existing beyond their immediate control as com- dazin is key to continuing youth hope and building plicit in the ongoing disempowerment and poor goals. health of local youth. Many Aboriginal communities conceive of self- The culturally relevant self-respect program respect in terms similar to the Algonquin concept of we developed is just one small step towards em- minododazin; therefore, modifications of our youth powering youth towards minododazin. Additional program to reflect these local worldviews would not efforts to reinforce Algonquin traditional values sur- be difficult. For example, among the Anishinabek rounding respect are essential. The youth requested of Manitoulin Island, the program could promote the development of a similar program to address health and well-being among youth through oper- drugs and alcohol; further, a program to empower ationalizing the local concept of mnaamodzawin, parents to take up these issues with their children meaning “good life” (Manitowabi and Shawande, would be welcomed by many in the community. 2011). The Anishnaabe term pimadaziwin (Hallowell, Many parents are struggling with their own history 1955) and its Cree equivalent mino-pimatisiwin of addictions and sexual abuse and thus need help (Adelson, 2004) may also be incorporated to guide themselves before they can help their own children. youth behaviour and conduct towards the “good” While we do not have longitudinal data on the in a framework that reflects the traditions of these effect of our program, there is research to suggest unique Indigenous philosophies. that programs of this nature are useful for youth. We believe our research provides further evi- Research on youth decision-making in regards to dence that using Indigenous health philosophies to sexual activity specifically has shown that promoting ground local health programs and policies is essen- self-respect and self-esteem among youth delays the tial; however, it must also be cautioned that doing age of sexual activity (Young et al., 2004). Further, so is not always straightforward. We have been very exposure to sexual health education is noted to help fortunate to work closely with the Kitiganik Health prevent negative outcomes such as STIs and HIV Clinic, where administrators and staff alike have among youth, as well as youth experiences of sexual supported and enabled Algonquin-based health coercion and sexual violence (Public Health Agency interventions while working alongside Western- of Canada, 2003). Further, from our local experience, based notions of health. Researchers must be sensi- youth who participated in the pilot and final pro- tive to the politics of funding, administration, and gram were very receptive to the ideas of self-respect power that are at play in the development of such and took pride in creating the animal hide art work. interventions, while seeking ways to challenge “top- Playing the game a number of times, the youth were down” discourses on community needs and inter- pleased as their scores increased as they correctly an- ests (Gardner and Lewis, 1996). In the Canadian swered an increasing number of questions. context, where Aboriginal peoples have experienced The bright and bold images and statements on systemic imposition of values and knowledge from the animal hide artwork transmit the powerful de- governing bodies dating back to the earliest days of sire of the youth to learn how to meet the many Western colonization, this point is especially crucial. challenges of adolescent life. Unfortunately, this de- sire is not necessarily enough to help youth over- Limitations come the many structural factors and challenges The study has two main limitations. First, the stu- they face as they grow through adolescence. In the dent researcher was not a local community member, interviews youth vocalized a desire for a positive fu- nor of Aboriginal heritage. Due to the delicate nature ture — for example, wanting to go to college, to be of research topic, some parents did not want a non- a doctor, or another career within the community. Aboriginal person speaking to their children about Unfortunately, many also were resigned to a future sexuality. Further, because the student researcher life of welfare and unemployment. Our program en- was not well-known to many of the community 10 © Pimatisiwin: A Journal of Aboriginal and Indigenous Community Health 10(1) 2012 members at the beginning of the study, some par- that a useful way to facilitate minododazin is to de- ents were concerned that she was professionally con- sign interactive and competitive programs and pro- nected to a government agency (e.g., Department of jects for the youth. The findings from this research Youth Protection) and therefore did not want their can therefore be read as a plea for meaningful social child to participate for fear that they might disclose change to help the youth learn more about minodo- personal family information that could be mis- dazin: how to respect themselves, their community, understood or taken out of context. Overall, how- their land, and their heritage. ever, the student researcher was well-accepted by the community as demonstrated by the favourable turn- References out and feedback in her final presentation. Aboriginal Canadian Portal. (2004). First Nation Second, in ethnographic research, the research- Connectivity Profile. Retrieved 8 February 2010 from er has the dual role of researcher and a research in- http://www.aboriginalcanada.gc.ca/abdt/apps/con- strument, which can create personal biases in the nectivitysurvey.nsf/vAllCProfile_en/296.html. research (Creswell, 2003). To reduce these biases, Aboriginal Nurses Association of Canada. (2002). the student researcher used a personal journal to Finding Our Way: A Sexual and Reproductive Health encourage reflexivity throughout the project, and Sourcebook for Aboriginal Communities. : debriefed regularly with supervisors at McGill and Aboriginal Nurses Association of Canada and health workers at the clinic. Planned Parenthood Federation of Canada. Adelson, N. (2004). ‘Being Alive Well’: Health and the Knowledge Translation Politics of Cree Well-being. Toronto: University of The self-respect program developed through this Toronto Press. project is owned by the community of Rapid Lake. It Assembly of First Nations and First Nations Information was developed in conjunction with the youth work- Governance Committee. (2007). First Nations er and the nurse and has been left in the community Regional Longitudinal Health Survey (RHS) 2002/03: along with a detailed guide outlining its compon- Results for Adults, Youth and Children living in First ents for future use. The animal hide remains in the Nations Communities. Second edition. Ottawa: RHS youth centre as a reminder to the youth and can National Team. be used by the youth worker to discuss different as- Clarke, H. (2007). Framework for Cultural Competency and pects of respect. The animal hide will not only be a Safety in Aboriginal Health Nursing: Living in Dignity reminder of what self-respect means but will also and Truth. Ottawa: Aboriginal Nurses Association provide the youth pride in their work. of Canada. During the final community presentation, com- Creswell, J.W. (2003). Research Design: Qualitative, munity members suggested that our findings will Quantitative, and Mixed Methods Approaches. Second resonate with other communities and encouraged edition. Thousand Oaks, CA: Sage Publications. us to share our work. They stressed the importance of sharing the findings so other communities can Fenton, K.A. (2001). Strategies for improving sexual health be aware of the disparities and also work to address in ethnic minorities. Current Opinions in Infectious Diseases, 14(1), 63–69. these concerns. Gardner, K. and Lewis, D. (1996). Anthropology, Develop­ Conclusion ment and the Post-modern Challenge. London: Pluto The community of Rapid Lake is well aware of the Press. social, historical, geographical, and political issues Goff, B.G. and Goddard, H.W. (1999). Terminal core val- that continue to challenge youth well-being in their ues associated with adolescent behavior problems. community. These issues work to prevent youth Adolescence, 34, 47-60. from applying minododazin to their lives to achieve Hallowell, A.I. (1955). Culture and Experience. Philadelphia: their ambitions and goals. This research suggests University of Pennsylvania Press. Minododazin: Translating an Algonquin Tradition of Respect into Youth Well-being in Rapid Lake, Quebec 11

Health Canada. (2009). First Nations, Inuit, and Aboriginal Wilkins. health: A statistical profile on the health of First Public Health Agency of Canada. (2003). Canadian Nations in Canada: Determinants of health, 1999– Guidelines for Sexual Health Education. Retrieved 5 2003. Retrieved 5 February 2010 from http://www. October 2010 from http://www.phac-aspc.gc.ca/ hc-sc.gc.ca/fniah-spnia/pubs/aborig-autoch/2009- publicat/cgshe-ldnemss/pdf/guidelines-eng.pdf. stats-profil/05-educat-eng.php. Reading, J. (2009). The Crisis of Chronic Disease among Koch, T. and Harrington, A. (1998). Reconceptualizing Aboriginal Peoples: A Challenge for Public Health, rigour: The case for reflexivity. Journal of Advanced Population, and Social Policy. Victoria, BC: Centre for Nursing, 28(4), 882–890. Aboriginal Health Research, University of Victoria. Lang, C., Macdonald, M.E., Carnevale, F., Lévesque, Sherman, J., Macdonald, M.E., Carnevale, F., and Vignola, M.J., and Decoursay, A. (2010). Kadiminekak S. (2011). The development and implementation of Kiwabigonem: Barriers and facilitators to fostering a type 2 diabetes prevention program for youth in community involvement in a prenatal program in the Algonquin community of Rapid Lake, Quebec. an Algonquin community. Pimatisiwin: A Journal of Pimatisiwin: A Journal of Indigenous and Aboriginal Indigenous and Aboriginal Community Health, 8(1), Community Health, 9(1), 219–244. 55–81. Speziale, H.J.S. and Carpenter, D.R. (2007). Qualitative Manitowabi, D. and Shawande, M. (2011). The meaning Research in Nursing: Advancing the Humanistic of Anishinabe healing and wellbeing on Manitoulin Imperative. Fourth edition. Philadelphia, PA: Island. Pimatisiwin: A Journal of Indigenous and Lippincott, Williams and Wilkins. Aboriginal Community Health, 9(2), 441-458. Steenbeek, A. (2004). Empowering health promotion: A Morrison-Beedy, D., Carey, M.P., Cote-Arsenault, D., holistic approach in preventing sexually transmit- Seibold-Simpson, S., and Robinson, K.A. (2008). ted infections among First Nations and Inuit ado- Understanding sexual abstinence in urban ado- lescents in Canada. Journal of Holistic Nursing, 22, lescent girls. Journal of Obstetric, Gynecologic, and 254–266. Neonatal Nursing, 37(2), 185–195. Tousignant, M. and Sioui, N. (2009). Resilience and Mussell, B., Cardiff, K., and White, J. (2004). The Mental Aboriginal communities in crisis: Theory and inter- Health and Well-being of Aboriginal Children and ventions. Journal of Aboriginal Health, 5(1), 43–61. Youth: Guidance for new Approaches and Services. Vancouver, BC: Mental Health Evaluation and Tu, A.W., Ratner, P.A., and Johnson, J.L. (2008). Gender Community Consultation Unit, University of differences in the correlates of adolescents’ canna- British Columbia. bis use. Substance Use and Misuse, 43, 1438–1463. Orkar, M. (1997). Taking Back our Children: A Conceptual Young, M., Donnelly, J., and Denny, G. (2004). Area Framework for Teaching Self-respect and Respect for specific self-esteem, values, and adolescent sexual Persons. Unpublished master’s thesis. University of behavior. American Journal of Health Education, 35, British Columbia, Vancouver, BC. 282–289. Polit, D.F. and Beck, C.T. (2006). Essentials of Nursing Research: Methods, Appraisal, and Utilization. Sixth edition. Philadelphia, PA: Lippincott, Williams and 12 © Pimatisiwin: A Journal of Aboriginal and Indigenous Community Health 10(1) 2012

Appendix A - Schematic Overview of Study Design

Individual Interviews Key Informants 3 Algonquin health care workers, 2 parents, 1 educator, 1 elder, 1 nurse Feedback Feedback

Group Interviews Grade 5/6 youth Presentation 10 participants (9-12 years Pilot Program Final Program Data of Findings to old; 5 boys, 5 girls) Grade 5/6 youth Data Grade 5/6 youth Analysis (feedback based) Community Analysis 5 participants Grade 3/4 youth Attended by 9 participants (2 boys, 3 girls) 4 participants (8–9 years (5 boys, 4 girls) 15-20 old; 3 boys, 1 girl) individuals

Focus Group Parents 110 Participants (3 fathers, 7 mothers)

Phase I Phase 2 Phase 3 Phase 4

------McGill Supervision ------Minododazin: Translating an Algonquin Tradition of Respect into Youth Well-being in Rapid Lake, Quebec 13

Appendix B

I take care of myself by: Doing drugs and drinking alcohol: A. taking a shower and making sure I look nice A. can prevent you from reaching goals in life B. never wash, brush, or comb my hair B. has no consequences, it’s just fun C. eating lots of fast food and drinking pop C. is healthy for my body If someone wants to kiss you and you say no I show respect to myself by: A. the person can hurt you and it’s your fault A. having pride in being Native because you were mean B. cutting myself B. you should feel guilty C. drinking alcohol and smoking marijuana C. it’s good because you should make your own decisions and have boundaries Please contact the lead author at heather.kooiman@ mail.mcgill.ca for a complete list of questions and for more information. 14 © Pimatisiwin: A Journal of Aboriginal and Indigenous Community Health 10(1) 2012

Appendix C

This image displays the outcome of the Self-Respect youth centre. The deer hide was donated for the ac- Art activity. The painting was done by youth, aged tivity by a local hunter. 9–12 years old and was displayed in the Rapid Lake Minododazin: Translating an Algonquin Tradition of Respect into Youth Well-being in Rapid Lake, Quebec 15

Heather Kooiman, MScN completed her Master’s Canada through narrative representations of pain, in Nursing at McGill University. Through the Global social suffering and hope in the context of incurable Health Program, she spent three months in the disease. She works as an assistant in the Division of community of Rapid Lake, Quebec completing a Oral Health and Society, Faculty of Dentistry, McGill clinical placement and research. This experience University. along with other work with Aboriginal people in Waylon Nottaway has been the Native Youth northern has confirmed her desire to con- Worker at the Kitiganik Health Clinic in Rapid Lake, tinue her nursing career in Aboriginal commun- QC since 2007. He is in charge of the Rapid Lake ities. She is working as a nurse in the community of Youth Centre that opened in 2010. He runs preven- Attawapiskat, Ontario. tion and awareness programs as well as tourna- Mary Ellen Macdonald, PhD is a medical anthro- ments and field trips for the youth of Rapid Lake. pologist in the Division of Oral Health and Society, Serge Vignola, RN, has been head nurse of the Faculty of Dentistry, McGill University. Her research Kitiganik Health Clinic in Rapid Lake, Quebec, since focuses on the health needs of underserved popula- 2004. In 1986 he took a nursing position with Health tions. Her main areas of research include access to Canada in an isolated Aboriginal community in services for urban Aboriginal peoples in , northern Quebec, and has since pursued a nursing and the health needs of Aboriginal Peoples in career focused on remote and isolated Aboriginal Northern Quebec. She also conducts research in community health. In 2008 he was involved in de- palliative care, focused on family bereavement after veloping a partnership between the Kitiganki Health the death of a child. Her interprofessional aca- Clinic and the McGill School of Nursing, which has demic appointments include the Departments of since resulted in a 3 month student nurse place- Pediatrics, Oncology, and the School of Nursing; ment every fall. He is committed to assisting local further, she is Core Faculty in the McGill Centre for Aboriginal health workers develop, implement, and Medical Education, Affiliate Member of the McGill sustain health promotion and prevention program- Biomedical Ethics Unit, and an Adjunct Professor in ming in an effort to ultimately improve the health the Department of Anthropology at the University of Rapid Lake community members. of Victoria. Franco A. Carnevale, RN, PhD, is a nurse, psych- ologist and clinical ethicist. He is a Professor in the School of Nursing, Associate Member in the Department of Pediatrics, Affiliate Member of the Biomedical Ethics Unit and Adjunct Professor in Counselling Psychology, all at McGill University. He is also Chair of the the Pediatric Ethics Committee and Associate Member in Pediatric Critical Care, both at the McGill University Health Centre and Clinical Ethics Consultant at Le Phare, Enfants et Familles (pediatric hospice and respite care). His principal areas of research relate to childhood eth- ics and childhood disability as well as inter-cultural care. Carolina Pineda, PhD is a doctoral candidate in the McGill Department of Anthropology. She is cur- rently writing a ethnography that explores the cul- tural contours of the chronic illness experience in